Source: University of Otago – Ōtākou Whakaihu Waka
Making positive shifts today to improve the nutrition of Pacific communities in the future is the hope of a University of Otago – Ōtākou Whakaihu Waka researcher.
Dr Edmond Fehoko, of the Department of Human Nutrition, is set to undertake a groundbreaking study into food neophobia, the fear of trying new food, among Pacific peoples in Aotearoa New Zealand.
He has received a Health Delivery Research Activation Grant worth $30,000 in the Health Research Council’s latest funding round. It is one of 15 activation grants, and one Health Delivery Research Career Development Award, worth a total of $540,087, awarded to Otago researchers.
“Food plays a significant role in our familial and cultural settings. However, there is a reluctance to eat so-called ‘new foods’ such as fruits, vegetables, seeds, nuts and wholegrain products. This, in turn, negatively impacts the health and wellbeing of Pacific families and communities.
“Pacific peoples need to shift behaviours, experiences and ideas around food, more specifically around the need to consume ‘new foods’,” Dr Fehoko says.
There is a lack of research into food neophobia across Pacific cultures and its potential link to nutritional status. He hopes this work will fill that gap and mark the start of broader research aimed at enhancing nutrition outcomes for Pacific peoples.
“While obesity rates continue to rise across New Zealand, Pacific communities are disproportionately affected due to disparities in healthcare and food environments. These health trends are largely driven by diet and limited access to healthy foods.
“My 3-year-old daughter is part of the inspiration for this work – if we can make positive shifts today, there is hope that there will be positive shifts of the nutrition status of Pacific communities in the future,” Dr Fehoko says.
Deputy Vice-Chancellor (Research and Enterprise) Professor Richard Blaikie is pleased HRC is funding this work and that of so many other Otago studies.
“These projects will help deliver benefit to real New Zealanders facing a myriad of health issues, at an individual and community level.
“We also welcome the fact that HRC’s support will benefit the career development of a number of emerging researchers working across our divisions and campuses. I look forward to seeing these people grow into our future research leaders.”
Health Delivery Research Activation Grant 1 recipients:
Dr Jennifer Dunn, Department of Orthopaedic Surgery and Musculoskeletal Medicine, Christchurch
Spinal Cord Injury Health Maintenance Tool (SCI-HMT)
12 months, $29,916
Spinal cord injury (SCI) impacts health, functioning and quality of life. Secondary health complications are common, and if not managed can be life-threatening and cause longer-term disability. GPs have a vital role in managing the long-term community-based nature of SCI. However, most GPs have very few people with SCI on their caseload and can consequently lack SCI-specific knowledge. To address this the Spinal Cord Injury Health Maintenance Tool (SCI-HMT) has been developed. It appears to be a promising tool to assist people with SCI and their GPs reduce health complications. However, it is important to determine whether the information in the SCI-HMT is relevant to the New Zealand context. The aims are to build capacity, establish relationships and engage with stakeholders as preparation for a follow-on study to implement the SCI-HMT in New Zealand; and, to identify and characterise any modifications that may enhance the SCI-HMT in the New Zealand context.
Dr Edmond Fehoko, Department of Human Nutrition
Food neophobia in Pacific cultures and its association with nutrition status
18 months, $30,000
Obesity remains a significant and persistent health challenge in Aotearoa New Zealand. While obesity rates continue to rise across New Zealand, Pacific Islander communities are disproportionately affected due to disparities in healthcare and food environments. These concerning health trends are largely driven by dietary habits and limited access to healthy foods. Food neophobia refers to the resistance of accepting new foods that are not within an individual’s typical diet. While extensively studied in Western contexts and integrated into national health policies in several European countries, the influence of food neophobia on dietary quality within a New Zealand context, particularly among Pacific communities, remains largely unexplored. This project aims to address this research gap by examining food neophobia across Pacific cultures and its potential links to nutritional status, making a crucial initial phase of a broader research endeavour aimed at enhancing health outcomes for Pacific peoples.
Dr Kathryn Hally, Department of Surgery & Anaesthesia, Wellington
Surveillance: Detecting perioperative myocardial injury in vascular surgery
15 months, $29,965
The global volume of surgery is on the rise and, while there have been significant advances in perioperative care, surgery remains associated with excess cardiovascular-related mortality and morbidity. Clinically silent myocardial injury (injury in the absence of cardiovascular signs/symptoms) is alarmingly common, is strongly associated with postoperative mortality and can only be detected with a cardiac troponin (cTn) surveillance programme. Patients with peripheral vascular disease undergoing surgery are at high-risk of experiencing this type of myocardial injury postoperatively, but we do not currently operate a cTn surveillance programme in this patient group in Aotearoa New Zealand. This provides a framework for investigating the utility of a cTn surveillance programme in vascular surgery, establishing a long-term biobank for monitoring postoperative cardiovascular complications in this patient group and developing a consensus cTn surveillance tool for diagnosing and managing cardiac injury in vascular surgery.
Dr Olivia Harrison, Department of Psychology
Whānau: The future of research in Aotearoa (Hui-a-Kairangahau i Turangawaewae)
6 months, $29,941
Health research in Aotearoa New Zealand needs a new strategy for meeting the needs of Māori communities, as promised in Te Tiriti o Waitangi. We propose to run a community research forum, where we will bring early research ideas to the community for open discussion and exchange. This will be held as a two-day event at Tūrangawaewae Marae, led by Iwi United Engaged Ltd. The forum will be embedded in kaupapa Māori and tikanga Māori practices, removing barriers and creating a platform for collaborative exchange between researchers in Aotearoa and Māori communities across the motu (country). “The creation of new science requires moving beyond simply understanding one another’s perspectives. We need to find transformative spaces for knowledge exchange and progress” (Ruckstuhl et al., 2021).
Dr Jerry Hsu, Department of Psychological Medicine
Cognitive bias modification towards marginalised populations in healthcare
18 months, $28,763
Health inequity is commonly experienced by marginalised populations and is a significant risk factor for developing health problems, in part due to biases. Existing bias trainings aim to shift intrinsic beliefs, which is time and cost-intensive. Our team has shown promising results from a “proof-of-principle” study demonstrating effectiveness of a novel, self-run bias training called Cognitive Bias Modification for Stereotype (CBM-S). CBM-S reduced medical students’ biases toward Māori in healthcare. In this proposed activation activity, by working with some of the other marginalised communities in Aotearoa New Zealand (e.g., Pasifika, Chinese, the rainbow community, elderly, and people with disability), we aim to extend CBM-S beyond a single training module to create additional CBM-S training modules for a wider reach into the healthcare system, including healthcare education and service providers. This would setup future studies to test CBM-S’ effectiveness in a spectrum of healthcare training programmes in Aotearoa New Zealand.
Associate Professor Josephine Johnston, Bioethics Centre
Reconsidering Aotearoa’s age restrictions on genetic testing: An HGDC case study
12 months, $30,000
In Aotearoa New Zealand, like many countries, genetic testing for adult-onset conditions is not performed in children. This rule rests on two ideas: that such testing offers no clinical benefit and that it breaches children’s future autonomy. It is supported by studies showing that adults value having a choice about genetic testing. However, the rule also stems from very specific Western philosophical traditions. Can and should it be altered to reflect te ao Māori? This question was recently raised by whānau in the context of genetic testing for CDH1 variants, which significantly increases risk of Hereditary Diffuse Gastric Cancer (HDGC), a potentially lethal condition that disproportionately affects Māori. This project will conduct a preliminary examination of positions, research, and experiences, build relationships, and identify knowledge gaps to design a full, te ao Māori-informed, investigation of the case for and against expanding HDGC and other genetic testing to children.
Dr SM Akramul Kabir, Department of Psychological Medicine, Christchurch
Feasibility study on long-term mental health of emergency responders to March 15
18 months, $29,388
Emergency responders (ERs) who deal with traumatic events such as terrorist attacks often experience high levels of stress, depression, and posttraumatic stress disorder (PTSD). The March 15 mosque terrorist attacks in 2019 had long-term psychological consequences for those involved. A Coronial inquest was conducted in late 2023 to examine the response with the aim to enhance emergency preparedness. However, it is likely that some ERs may have felt retraumatized during the confrontational court sessions. This feasibility study is exploratory to understand the potential magnitude of the problem and how acceptable this study would be for ERs. The longer-term aim of this study is to identify the feasibility for conducting a full-length study on the mental health and wellbeing of the March 15 Emergency Responders, and connect them to appropriate supports or therapeutic services, as appropriate.
Miss Talai Mapusua, Va’a o Tautai – Centre for Pacific Health
The ‘m’ word – the stories of Samoan women who have suffered a miscarriage
12 months, $26,041
This project focuses on building a community of intergenerational Samoan women who have experienced a miscarriage and are living in Dunedin and other areas in the Otago region which have a growing Samoan population such as Oamaru and Balclutha. Building relationships with these women using Samoan cultural practices and approaches is the initial and key step to this project before capturing their experiences through engagement known as ‘talanoaga’, which can represent both formal and informal discussion that is ongoing and has no time limit or restrictions which invites and encourages sharing of thoughts and ideas. Gathering these women’s experiences and stories aims to highlight what level of support and care is available and whether they meet the needs of Samoan women through a cultural lens.
Dr Jessica McCormack and Dr Mei Peng, Department of Food Science
Understanding the relationship between sleep and chemosensory dysfunction
12 months, $30,000
Smell and taste play an important role in determining our food choices and general health. These senses can be impaired by environmental exposures, as well as life experiences and modifiable lifestyle factors. One factor that may influence smell and taste perception is sleep quality and duration however, there is limited research in this area. The aim of this research is to understand what is known so far about the relationship between sleep and smell and taste function, what the gaps are, and the direction for future research. The research has important implications for nutrition in ageing and understanding the relationship between sensory perception and obesity.
Dr Nathan Monk, Māori Indigenous Health Innovation, Christchurch
Complex colonisation: Mapping determinants of Māori health inequity
4 months, $29,631
This grant will fund research activation activities for the proposed future research project, titled “Complex colonisation: Mapping determinants of Māori health inequity”. Research activation activities comprise all necessary steps to take the proposed research idea from its current conception to realisation through developing necessary knowledge and connections for a successful Health Delivery project. Specifically, activation of the proposed future research will include: 1. A comprehensive literature survey. 2. Re-connect with current colleagues regarding the project. 3. Reach out to possible external collaborators. 4. Finalise project proposal. The proposed future project will quantitatively investigate the social determinants of Māori health inequity using a complex systems theoretical framework.
Dr Sherly Parackal, Department of Preventive and Social Medicine, and Associate Professor Kirsten Coppell, Department of Medicine
Improving service delivery and health outcomes for NZ South Asians
6 months, $29,972
South Asians (SAs) comprise 6 per cent of the New Zealand population and have a high risk for and higher prevalence of cardiometabolic diseases (CMDs). The associated risk factors such as obesity, dyslipidaemia, hypertension, pre-diabetes, and gestational diabetes are also highly prevalent, which could be better managed in a primary care setting to reduce the risk of CMDs in New Zealand SAs. However, previous research has shown that Asians face navigational challenges and poorer engagement with primary health care services which can negatively impact health outcomes. Effective communication, confidence in the health care provider and continuity of care have been identified as three key components of a patient-centric care model for migrants and refugees in high-income countries. Using available data, we aim to assess the needs of SA patients to achieve effective communication and confidence in their healthcare provider and continuity of care to improve health outcomes and achieve health equity for New Zealand SAs.
Dr Mei Peng and Dr Jessica McCormack, Department of Food Science
Assessing feasibility of an RCT on intermittent fasting and cognitive health
18 months, $30,000
Cognitive health, encompassing abilities of learning, remembering, problem solving, and using information, is vital to individual well-being. In Aotearoa, approximately 16 per cent of the population aged over 60 experiences cognitive impairments, with prevalence rates varying across ethnicities. Emerging research, including our own, has suggested that intermittent fasting (IF) holds promise in enhancing cognitive functions. Consequently, there is a pressing need for a well-powered Randomised Controlled Trial (RCT) to comprehensively evaluate IF’s impacts on cognitive health and overall well-being. This activation project aims to assess the feasibility and acceptability of conducting such an RCT, by soliciting feedback from participants involved in our previous pilot study and engaging with members of the community, with particular a focus on the Māori and Pacific communities. This project serves as a critical opportunity to involve key stakeholders at an early stage, ensuring a robust and successful implementation of the planned health intervention.
Dr Lara Vlietstra, School of Physical Education, Sport and Exercise Sciences
Taiao to Tēpū
12 months, $30,000
The prevalence of non-communicable diseases (NCDs) are a major public health issue, globally and within Aotearoa. Unless dramatic changes to the environment we live in occur, such as ensuring access to healthy food, safe and accessible places to be physically active and creating places to connect as communities, we will likely see a further decline in health and wellbeing in our population. Community gardens and maara marae have the potential to improve holistic health and wellbeing through connecting communities to the taiao, incorporating the Māori worldview to achieve better outcomes both for Māori and across other groups. This research aims to build a solid foundation of knowledge around the scientific evidence of gardening for health and wellbeing, as well as gain a thorough understanding of what already exists in our communities and how we can build on this mahi to implement successful, thriving community gardens throughout Aotearoa.
Dr Catherine Wall, Department of Medicine, Christchurch
Information needs of Māori and non-Māori after bowel cancer surgery
9 months, $29,998
The cancer-related health information needs of New Zealand patients has not yet been described but based on the current evidence, it is likely that health information needs are not met. The information needs and preferences for how this is delivered may differ between cultures. This project has two objectives: 1. to understand the perioperative health information needs of patients who have had surgery to treat bowel cancer; 2. to understand what health information is routinely provided by clinicians to patients with bowel cancer. The team will interview Māori and non-Māori who have undergone, or supported a whānau member who has undergone, colorectal surgery to treat bowel cancer. They will also survey bowel cancer surgeons, nurses and support staff to understand if there is inequity in health information provision and perceived needs across Aotearoa.
Associate Professor Lincoln Wood, Department of Management, and Dr Mona Koushan, University of Canterbury
System-wide perspectives on surgical delays: Ethnicity and socioeconomic factors
18 months, $30,000
This project aims to improve how hospitals manage their limited surgical resources to better meet the growing demands of patients. Currently, hospitals face challenges such as limited resources, long waiting lists, and staff burnout. This study looks beyond the usual hospital team to include patients, their whānau, and community members in the planning process. By considering cultural, social, and economic factors, the project seeks to understand how these wider groups can influence the efficiency and effectiveness of surgical services. The goal is to develop new strategies that include these overlooked stakeholders, aiming to reduce surgery delays and cancellations, improve access to services, and ensure fair treatment for all, especially for marginalised communities, such as the Māori and Pacific populations in New Zealand. This approach could lead to better surgical outcomes and more equitable healthcare.
Health Delivery Research Career Development Award 1 recipient:
Mrs Kylie Head, Department of Orthopaedic Surgery and Musculoskeletal Medicine, Christchurch
The return-to-work experience for people and whānau with mild-moderate stroke
24 months, $96,472
Each year, more than 8,000 New Zealanders experience the life-altering impact of stroke. Stroke survivors face a complex transition as they strive to return to work (RTW). People who experience mild to moderate stroke are often discharged quickly following their initial stroke with little physical impairment. The extent of cognitive or emotional impairments are often not realised until challenges such as RTW occur. This study aims to firstly, explore the models, processes and outcomes used in vocational rehabilitation to support RTW in people with mild to moderate stroke using a systematic scoping review. Then researchers will conduct a longitudinal prospective study to explore the RTW experiences of people with mild-moderate stroke and whānau over 12 months admitted to Te Whatu Ora-Counties Manukau Hospital Auckland.
